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ABOUT THE HSC HEALTH CARE SYSTEM
The HSC Health Care System is a nonprofit organization combining the resources of a care coordination plan; (Health Services for Children with Special Needs, Inc.), pediatric specialty hospital (The HSC Pediatric Center), home health agency (HSC Home Care, LLC), and parent foundation (The HSC Foundation) to offer a comprehensive approach to caring, serving and empowering people with disabilities. The HSC team of 750 employees and more than 100 volunteers together serve children and young adults with special health care needs and their families at our District of Columbia and Maryland locations.
ESSENTIAL HSC MISSION AND VALUES
Mission Statement
HSC Health Care System provides and coordinates innovative, high quality, community-based care for individuals with complex needs and their families. HSC empowers all we serve to improve the quality of their lives.
Organizational Beliefs
HSC supports individuals and families to maximize their potential. The following beliefs drive our work. HSC believes that:
- A culturally diverse community is a strength.
- Inclusiveness for individuals, families, and staff promotes positive outcomes.
- Everyone should be treated with compassion and empathy.
- Our skillful, dedicated, and resourceful staff is key to our success.
- We must continually adapt to the changing needs of our community.
- Increased independence is an important goal for individuals and their families.
POSITION SUMMARY
The Manager, Clinical Resource & Community Care Management will report to the Director of Integrated Care Management. The Manager will lead, supervise, and evaluate the daily work of the Children's National Rehabilitation and Specialized Care Nurse Care Management and Social Work team, and Community Health Programs within the enterprise in accordance with departmental and organizational policies. Provide education within the inpatient setting and community health programs, departments, and the organization at large on clinical care, levels of care, and financial issues. Lead the clinical and financial processes that impact authorization for inpatient and outpatient services, net collections for hospital-based services, and pay for performance projects in the ambulatory settings. Analyze and report data related to case management activities, payer activities, resource utilization, and clinical denials. Lead hospital wide initiatives on behalf of the department. Define the role for care management by optimizing performance outcomes through readmission prevention, low acuity non-emergency (LANE) ED avoidance and reducing inpatient length of stay through comprehensive care planning that supports the highest level of symptom management in the home, school, community and/or ambulatory clinic.
Minimum Education
Master's Degree: Master of Nursing degree or equivalent (Required)
Minimum Work Experience
7 years Clinical nursing experience (Required) And
5 years Case Management related experience including care coordination, discharge planning, utilization review, clinical auditing, operational leadership, and financial/clinical data reporting. (Required)
3 years Some supervisory experience with executive level leadership (Preferred)
Required Skills/Knowledge
Facile with keyboarding and familiar with software such as Windows environment (i.e., Microsoft Office, Word, PowerPoint, Excel, Access).
Excellent written and verbal communication and presentation skills. Knowledge of children's health issues.
Knowledge of cultural issues and their impact on health care. Strong focus on Service Excellence and patient experience.
Working experience with medical management criteria such as MCG and/or InterQual.
Demonstrated success in managing day-to-day operations of case management and care coordination functions for a department and/or medical center that includes inpatient and ambulatory service lines.
Track record of meeting department goals without an adverse impact on employee morale or customer service
Ability to analyze and present productivity and outcome data using Microsoft Access and Excel.
Ability to plan, implement, and effect transformation from a "transaction" orientation to a high-quality customer service orientation which includes the physicians, patients, and community service providers as customers.
Knowledge of general business concepts including financial management and accounting principles and practice.
Ability to analyze and present complex financial, productivity and outcome data using software and data warehouse tools.
Experience with Cerner systems preferred.
Required Licenses and Certifications
Registered Nurse in District of Columbia (Required)
Basic Life Support for Healthcare Provider (BLS) (Required)
CCM or ACMA (certified case manager) (Preferred)
Job Functions
Resource Management
Operations Management
Education
Performance Improvement/Outcomes Management
Organizational Accountabilities
Organizational Accountabilities (Managers)
Leadership Excellence
Collaboration
Leadership Skills
Supervisory Responsibilities
Blood Borne Pathogen Exposure
Protected Health Information Access Level
Working Environment
Physical Requirements
Travel Requirements
Other
Hospital
$162k-218k (estimate)
04/09/2024
06/08/2024
www.childrensnational.org
Washington, District of Columbia
3,000 - 7,500
Eric McMillan
$500M - $1B
Hospital
Founded in 1870, Children's National Medical Center (CNMC) is a children's hospital in Washington, D.C., located just north of the McMillan Reservoir and Howard University. It shares grounds with Washington Hospital Center, National Rehabilitation Center, and the DC Veterans Affairs Medical Center.